Definition:
Anal stenosis refers to a narrowing of the anal opening, which makes it difficult for stool contents to pass through easily. Symptomatic children tend to be particularly colicky babies, because of the discomfort associated with the stool backing up. The stool may exit under pressure and look almost like a squirt gun. Treatment of this disorder usually involves gentle dilation of the anal opening. This is typically done twice a day. Every week a slightly larger lubricated dilator is passed to stretch the anus until it reaches normal size. In very mild cases, softening the stool may be sufficient until the anus grows sufficiently. Suppositories can make the child comfortable in the short run, but do run the risk of dependence. At around 4 months, apple or even prune juice may help the child to pass stool. Rarely, surgery is needed to insure an opening of adequate caliber. If this is an isolated anomaly, the prognosis is excellent.

You may click to see the picture
Some children are born with no anal opening at all. This is called an imperforate anus. The rectum ends in a blind pouch, about 2 cm inside the perianal skin. Usually the sphincters are well developed. For these children, a colostomy is indicated during the newborn period, but once the final surgery corrects the defect, the prognosis is likewise excellent.

The most frequent anorectal defect seen in boys is the recto-urethral fistula, or a communication between the rectum and the lower part of the urethra. These children also require a colostomy before the definitive repair period. The long term prognosis for normal urethral and rectal function is good.

Scar formation after perianal fistulae, trauma, severe anal sac disease, or treatment for neoplasia may result in a reduced lumen and particularly a loss of the capacity to dilate with passage of feces. Straining, passage of ribbon-like feces and constipation result.

Symptoms
The restriction of the anal canal prevents the normal expulsion of faeces, resulting in difficulty and pain when trying to open the bowels, and leading to constipation. Babies may also experience pain when trying to open their bowels.

Causes and risk factors:
Anal stenosis may be present from birth, when it might be accompanied by malformations of the anal opening. This happens in one in several thousand births.

Sometimes the opening appears further forward than normal. In girls, it’s usually immediately behind or inside the female genitalia. In boys, there may be no obvious opening at all or just a small area of bulging skin or a tiny channel under the skin.

More commonly, stenosis develops as a result of scarring from a tiny fissure, or crack, in the anal canal. This is usually the reason why adults develop anal stenosis, but it can also occur in babies.

Anal stenosis may also develop after surgery to the anus, for example after the removal of piles or haemorrhoidectomy.

Treatment and recovery:Low-risk treatments:

Laxatives, suppositories and other treatments are used to help loosen motions and lubricate the anal canal, to make it easier to empty the bowels. There’s little risk the person affected will come to any harm from these treatments if they’re used as prescribed and only for a matter of months while the problem settles. (It must be remembered that the risks are considerably less than those that might occur if the affected person becomes very constipated).

One solution to this problem is to simply insert a plastic tube known appropriately as an “anoscope” and relieve the obstruction. ..You may click to see the picture.

Individuals suffering from anal stenosis aren’t likely to become dependent on the laxatives and suppositories.

However, its also important to make dietary changes (such as plenty of raw fruit and vegetables to provide natural fibre, and plenty of fluid to avoid dehydration) in order to keep the motions soft. Regular exercise also helps keep a regular bowel habit.

Surgical treatments:
In mild cases, gentle and gradual dilation by the regular passage of normal motions may be enough. But quite often surgery is needed, especially in more severe cases. The surgical treatment of anal stenosis depends on the extent of the problem. In most cases all that’s needed is for the anal canal to be stretched. Often this can be done by the doctor in the hospital clinic, without the need for anaesthetic.

If the stenosis is severe, dilation may performed under anaesthesia. More major surgery is only needed if the anal canal needs reconstructing or (in small children with congenital anal stenosis) it needs repositioning or there are other malformations that require surgery.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Anoscopy views the anus and anal canal by using an anoscope. An anoscope is a plastic, tube-shaped speculum that is a smaller version of a sigmoidscope. Before the anoscope is used, the doctor completes a digital rectal examination with a lubricated, gloved index finger. The anoscope is then lubricated and gently inserted a few inches into the rectum. This procedure enlarges the rectum to allow the doctor to view the entire anal canal with a light. If any suspicious areas are noticed, a piece of tissue can be biopsied.What is the Purpose of the test?Doctors use anoscopy to diagnose rectal cancer and cancer of the anus. This procedure can also help the doctor:

*:detect any lesions that could not be felt during a digital examination

*determine whether squamous cell carcinomas involving lymph nodes in or near the groin (inguinal lymph nodes) originated in the genital area or in or near the anus or rectum

*confirm the source of malignancies that have spread to the anorectal area from other parts of the body
Doctors also perform anoscopy to determine whether a patient has hemorrhoids or anal:

What happens when the test is performed?
This test is usually done in a doctor’s office. You need to remove your underwear.After removing underwear, the patient bends forward over the examining table or lies on one side with knees drawn up to the chest. The doctor performs a digital examination to make sure no tumor or other abnormality will obstruct the passage of a slender lubricated tube (anoscope). As the doctor gently guides the anoscope a few inches into the rectum, the patient is told to bear down as though having a bowel movement, thenrelax.

By tensing and relaxing, the patient makes it easier for the doctor to insert the anoscope, and discover growths in the lining of the rectum that could not be detected during the digital examination.

Directing a light into the anoscope gives the doctor a clear view of any tears or other irregularities in the lower anus or rectum. A doctor who suspects that a patient may have cancer will remove tissue for biopsy in the course of this procedure.

Slowly withdrawing the anoscope allows the doctor to thoroughly inspect the entire anal canal. As the procedure is being performed, the doctor explains what is happening, and why the patient feels pressure.

Removing tissue samples for biopsy can pinch, but anoscopy does not usually cause pain. Patients do experience the sensation of needing to have a bowel movement.

Risk Factors:
There are no significant risks from anoscopy. Sometimes, especially if you have hemorrhoids, you may have a small amount of bleeding after the anoscope is pulled out.

Must you do anything special after the test is over?
You can return to your normal activities immediately.How long is it before the result of the test is known?
Your doctor can tell you about your anoscopy exam right away.

RESULTS:

Normal Results

A normal anoscopy reveals NO evidence of:

*tumor
*tissue irregularities
*polyps
*fissures
*hemorrhoids
*inflammation
*infectionor other abnormalities. The size, color, and shape of the anal canal look like they should.

How the test is performed:
First, the health care provider performs a digital rectal exam by inserting a lubricated, gloved finger into the rectum to determine if anything will block the insertion of the scope.

He or she then inserts a lubricated metal or plastic anoscope a few inches into the rectum. This enlarges the rectum to allow the health care provider to view the entire anal canal using a light. A specimen for biopsy can be taken if needed. As the scope is slowly removed, the lining of the anal canal is carefully inspected.

How to prepare for the test:
Before the test, you might want to empty your bladder or have a bowel movement to make yourself more comfortable.
You will be asked to defecate to clear your rectum of stool before the procedure. A laxative, enema, or other preparation may be administered to help clear your rectum.

Infants and children:
A child’s age and experience determine which steps are appropriate to help prepare him or her for this procedure. For specific recommendations, refer to the following topics:

What happens when the test is performed?
This test is usually done in a doctor’s office. You need to remove your underwear. Depending on what the doctor prefers, you either lie on your side on top of an examining table, with your knees bent up to your chest, or bend forward over the table. The anoscope is 3 to 4 inches long and the width of an average-to-large bowel movement. The doctor coats the anoscope with a lubricant and then gently pushes it into your anus and rectum. The doctor may ask you to “bear down” or push as if you were going to have a bowel movement, and then relax. This helps the doctor insert the anoscope more easily and identify any bulges along the lining of the rectum.

By shining a light into this tube, your doctor has a clear view of the lining of your lower rectum and anus. When the test is finished, the anoscope then is pulled out slowly.

You will feel pressure during the examination, and the anoscope will make you feel as if you are about to have a bowel movement. Do not be alarmed by this sensation; it is normal. Most patients do not feel pain from anoscopy.

How the test will feel:
There will be some pressure during the procedure, and you may feel the need to defecate. If biopsies are taken, you may feel a pinch.

Risk Factors:
There are no significant risks from anoscopy. Sometimes, especially if you have hemorrhoids, you may have a small amount of bleeding after the anoscope is pulled out.

Must you do anything special after the test is over?
You can return to your normal activities immediately after the test.

How long is it before the result of the test is known?
Your doctor can tell you about your anoscopy exam right away.

Habitat:
Preferentially grows in forests and secondary open scrub and is in heights up to 1000-1200 meters . It is especially distributed in the monsoon forests and, less frequently, has reached parts of Oceania and America . It is located in Asia especially in India , in the tropical forests of central and southern Iraq, in Western Ghats is a mountain range that lies west of India and in the territory of Goa . It also grows in Japan , Sri Lanka , Vietnam , Taiwan and some provinces of China in Fujian , Guangxi , Hainan , Yunnan and Zhejiang . Less commonly can be found in South Africa .

Madhunashini is an evergreen climber and the best season for planting is June-July. After the ploughing and leveling of the land, 45 cm3 sized pits are made at a distance of 2.5 m between the rows and 1.75 m between plants (within the row). The pits are dug open 15 days earlier to planting, they are filled with green leaves and top soil and 2 kgs of well rotten manure per pit is added. The pits are to be irrigated and left for one week, then the rooted cuttings are planted in the pits.

HARVESTING AND YIELD
The crop is ready for harvest two years after planting. Leaves are the economic part and the harvesting of the leaves begins when plants start flowering i.e., during end of June or first week of July. Leaves can be harvested along with flowers either by hand or can be cut with sickle/knife. The harvest leaves are dried under shade by allowing sufficient air to circulate by spreading thinly on clear ground for about7-8 days. Direct sunlight should be avoided to maintain the quality of the leaves.

The crop is harvested only once in a year during flowering and on an average 5-6 kg dried leaves per plant can be obtained from a 4 years old plant yielding about 10,000 – 15,000 kgs of dried leaves per hectare. The crop can be cultivated for 10-15 years under good management.

Medicinal Property & Uses: The plant is stomachic, stimulant, laxative and diuretic. It is good in cough, biliousness and sore eyes. If the leaves of the plant are chewed, the sense of taste for sweet and bitter substances is suppressed (Gent, 1999, Persaud et al., 1999, Intelegen, 2004). The leaves are said to be used as a remedy for diabetes (Prakash et al., 1986; Shanmugasundaram et al., 1990; Grover et al., 2002; Gholap & Kar, 2003}. It has been included among the most important herbs for all doshas (Mhasker & Caius, 1930; Holistic, 2004). It has shown effective activity against Bacillus pumilis, B. subtilis, Pseudomonas aeruginosa and Staphylococcus aureus (Satdive et al., 2003). Tribals in Chhindi rub the leaves on infected body parts to cure infections.

Traditional healers from various states of India use this plant in various ailments. Leaf is given in gastric troubles in Rajasthan. Traditional healers of Maharastra prescribe it in urinary problems and stomachache whereas in Madhya Pradesh, tribals and local healers apply the leaf extract in cornea opacity and other eye diseases. In Andhra Pradesh it is used in glycosuria.

In Indian Ayurveda it is mainly used in the treatment of Diabetes, hydrocil & Asthama.

It is the need of the hour to save this highly important medicinal plant of Patalkot valley. If proper initiatives would not be taken in time, there would not be single Gymnema plant in the valley. It is urged to the scientists, conservationists, researchers, NGO’s and other bodies to come forward and take moves to protect this important herb. Local farmers should be encouraged to cultivate this herb. Government and policy makers are having lots of plans/ ideas but they find problems in proper implementations. It is the youth and people from literate world who should come forward to take this task in their hands.

Caution: If the indicated amounts are used, ie no more than 400mg per day is generally safe, well tolerated and no side effects. During pregnancy and lactation has not been determined whether or not there may be side effects. Still, it is recommended to consult a medical practitioner before taking Gymnema extract diabetic children and elderly. Contraindicated if used in combination with oral hypoglycemic drugs. Be careful when taking gymnema with glipizide, glyburide and insulin.

Disclaimer:The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.

Piles (Haemorrhoids) are enlarged, painful veins in the rectum. They are also known as hemorrhoids. It is a condition in which inflammation takes place in the veins around the anus or lower rectum. Piles can be internal or external. External piles are painful, but do not involve much of bleeding. On the contrary, internal piles witness the release of dark blood. It is an ailment that has become very common in todays society….click & see

Haemorrhoids are very common. They are said to be more common in countries where the diet has traditionally been more processed and low in fibre. The main contributory causes are those things that cause us to raise the pressure in the abdomen. This causes the blood vessels to swell and become engorged.

It seems that the people most at risk of developing haemorrhoids are those who have more causes for raised abdominal pressure

Treatment:

It is usually best, with haemorrhoids, to get by with the least treatment possible, as even after the most extensive treatments they may still return.

Many times they will settle down over a matter of days without any treatment.

Cream or suppositories (bullet-shaped tablets to be inserted into the anus) may be bought over the counter, or your doctor may prescribe one. These soothe itching and pain, and cause swelling and bleeding to diminish.

Cold compresses, even ice can be helpful.

If you do not get better with these approaches, your doctor may ask a specialist to see you who may:

Put little rubber bands round the haemorrhoids, which will cause them to shrivel and wither away.

Inject a substance into the haemorrhoids which causes them to wither away (sclerotherapy).

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.